Search results for: meta-analytic prior
888 Social Workers' Perspectives on Muslim Parents with Intellectual Disabilities
Authors: Ayelet Gur
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Background: Parents with intellectual disability are of great interest to social service professionals. Article 23 of the United Nations Convention on the Rights of Persons with Disabilities aims to ensure that persons with disabilities can create a family by providing adequate supports. The aim of the current investigation was to portray families with parents with intellectual disabilities within Muslim- Arab society in Israel. Method: Qualitative method using semi-structured interviews with nine-teen Muslim Israeli social workers was employed. Thematic analysis was used to identify major themes. Results: Families with parents with intellectual disability are not a rare phenomenon in the Arab society. The common type is of marriage between a man with intellectual disability and a woman without disability. Findings indicated two main motives for the arranged marriage of a man with intellectual disability: the extended family's concerns about his future and their desire for the family continuity. The non-disabled wives' motives for marrying men with intellectual disabilities revolved around their lack of other opportunities to create a family and their desire to leave their parents' household and live independently. Those women were described as partly or fully aware of their husbands' disability prior to the marriage. The family life of those families were described in relation to the fathers' involvement in family life and relation to the wives' high burden and in many cases, acceptance of their life situation. Conclusions: Findings are discussed with respect to religious values on disability, arranged marriage and the status of Muslim women. Services and supports for parents with intellectual disabilities should be developed with respect to the cultural values and norms.Keywords: Arab society in Israel, intellectual and developmental disability, parents with intellectual disability, social work
Procedia PDF Downloads 154887 Parental Engagement with Their Preschoolers’ Cognitive Development Prior to Their Kindergarten Admission: Sharjah-Based Case Study
Authors: Nada Mohammad Eljeshi
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In the United Arab Emirates (UAE), preschoolers can enroll in kindergarten after completing four years old by August 31 of their admission year. This study aims to better understand how Sharjah-based parents’ engagement with preschoolers contributes to their phonological awareness, literacy development, and print knowledge before their kindergarten admission considering cognitive development is addressed in the UAE national child care standards. More specifically, it will discuss the importance of cognitive development activities to preschoolers, the rationale behind defining the admission age to kindergarten and compare and benchmark the policy to other countries. To achieve this study's objectives, an online survey was conducted and distributed. Respondents were asked 13 dichotomous questions related to activities that promote the preschooler’s linguistics literacy and cognitive development. The results suggested parents’ emphasis on phonological awareness, followed by developing their print knowledge. However, the majority of the surveyed parents did not engage in literacy development with their preschoolers. On this basis, it is clear parents’ awareness should occur by introducing various activities such as book reading, that there is a need to introduce and encourage parents to various activities such as reading a printed book and drawings to keep up with their children's cognitive development. The survey results suggested an emphasis on phonological awareness, followed by developing their print knowledge. However, the majority of the surveyed parents did not engage in literacy development with their preschoolers. On this basis, parental awareness of the importance of preschoolers' cognitive development should be developed and engage the parents in understanding their preschooler’s cognitive development before entering kindergarten.Keywords: preschoolers, cognitive development, parental engagement, Sharjah-based case study
Procedia PDF Downloads 247886 Modelling of Pipe Jacked Twin Tunnels in a Very Soft Clay
Authors: Hojjat Mohammadi, Randall Divito, Gary J. E. Kramer
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Tunnelling and pipe jacking in very soft soils (fat clays), even with an Earth Pressure Balance tunnel boring machine (EPBM), can cause large ground displacements. In this study, the short-term and long-term ground and tunnel response is predicted for twin, pipe-jacked EPBM 3 meter diameter tunnels with a narrow pillar width. Initial modelling indicated complete closure of the annulus gap at the tail shield onto the centrifugally cast, glass-fiber-reinforced, polymer mortar jacking pipe (FRP). Numerical modelling was employed to simulate the excavation and support installation sequence, examine the ground response during excavation, confirm the adequacy of the pillar width and check the structural adequacy of the installed pipe. In the numerical models, Mohr-Coulomb constitutive model with the effect of unloading was adopted for the fat clays, while for the bedrock layer, the generalized Hoek-Brown was employed. The numerical models considered explicit excavation sequences and different levels of ground convergence prior to support installation. The well-studied excavation sequences made the analysis possible for this study on a very soft clay, otherwise, obtaining the convergency in the numerical analysis would be impossible. The predicted results indicate that the ground displacements around the tunnel and its effect on the pipe would be acceptable despite predictions of large zones of plastic behaviour around the tunnels and within the entire pillar between them due to excavation-induced ground movements.Keywords: finite element modeling (FEM), pipe-jacked tunneling, very soft clay, EPBM
Procedia PDF Downloads 82885 Greenlight Laser Prostatectomy: A Safe and Effective Day Case Option for Bladder Outlet Obstruction in the Elderly Population
Authors: Gordon Weight, Hermione Tsoi, Patrick Cutinha, Sanjay Rajpal
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Aim: Greenlight-laser prostatectomy (GLLP) is becoming a popular treatment option for bladder outlet obstruction and lower urinary tract symptoms (LUTS). In this retrospective study, we aim to explore the patient selection, perioperative morbidity, and functional outcomes of GLLP. Methods: Patients who underwent GLLP at a UK tertiary centre between June 2018 and November 2021 were included in this study. Retrospective data covering patient demographics, perioperative parameters and postoperative outcomes were collected using the electronic records systems. Results: 305 patients were included in this study with a mean age of 73 (range 30-90) years. The most common indication (62.6%) for the procedure was patient’s wish to be free from long-term catheters (LTC) or intermittent catheterisation (ISC), followed by failed medical therapy for LUTS (36.4%). 84.6% of patients had an ASA ≥2, and 32.1% took anticoagulant or antiplatelet therapy. Inpatient stays were minimal, with the majority (68.2%) of patients were performed as day case, and only 10.5% of patients requiring more than a single night admission. The 3-month readmission rate was 10.8%, with the most common causes being haematuria and urinary-tract infection. The successful TWOC rate at follow up was 91.2%. Amongst the 19 patients who failed TWOC, 14 had LTC prior to the procedure and 4 had been performing ISC. Conclusions: Our study shows that GLLP is a safe and effective day case treatment and can be suitable for elderly and comorbid patients. Patients requiring LTC or ISC pre-operatively should be counselled carefully about the risk of not being catheter-free post procedure.Keywords: urology, endourology, prostate, bladder outlet obstruction, laser
Procedia PDF Downloads 68884 A Bayesian Population Model to Estimate Reference Points of Bombay-Duck (Harpadon nehereus) in Bay of Bengal, Bangladesh Using CMSY and BSM
Authors: Ahmad Rabby
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The demographic trend analyses of Bombay-duck from time series catch data using CMSY and BSM for the first time in Bangladesh. During 2000-2018, CMSY indicates average lowest production in 2000 and highest in 2018. This has been used in the estimation of prior biomass by the default rules. Possible 31030 viable trajectories for 3422 r-k pairs were found by the CMSY analysis and the final estimates for intrinsic rate of population increase (r) was 1.19 year-1 with 95% CL= 0.957-1.48 year-1. The carrying capacity(k) of Bombay-duck was 283×103 tons with 95% CL=173×103 - 464×103 tons and MSY was 84.3×103tons year-1, 95% CL=49.1×103-145×103 tons year-1. Results from Bayesian state-space implementation of the Schaefer production model (BSM) using catch & CPUE data, found catchabilitiy coefficient(q) was 1.63 ×10-6 from lcl=1.27×10-6 to ucl=2.10×10-6 and r= 1.06 year-1 with 95% CL= 0.727 - 1.55 year-1, k was 226×103 tons with 95% CL=170×103-301×103 tons and MSY was 60×103 tons year-1 with 95% CL=49.9 ×103- 72.2 ×103 tons year-1. Results for Bombay-duck fishery management based on BSM assessment from time series catch data illustrated that, Fmsy=0.531 with 95% CL =0.364 - 0.775 (if B > 1/2 Bmsy then Fmsy =0.5r); Fmsy=0.531 with 95% CL =0.364-0.775 (r and Fmsy are linearly reduced if B < 1/2Bmsy). Biomass in 2018 was 110×103 tons with 2.5th to 97.5th percentile=82.3-155×103 tons. Relative biomass (B/Bmsy) in last year was 0.972 from 2.5th percentile to 97.5th percentile=0.728 -1.37. Fishing mortality in last year was 0.738 with 2.5th-97.5th percentile=0.525-1.37. Exploitation F/Fmsy was 1.39, from 2.5th to 97.5th percentile it was 0.988 -1.86. The biological reference points of B/BMSY was smaller than 1.0, while F/FMSY was higher than 1.0 revealed an over-exploitation of the fishery, indicating that more conservative management strategies are required for Bombay-duck fishery.Keywords: biological reference points, catchability coefficient, carrying capacity, intrinsic rate of population increase
Procedia PDF Downloads 124883 Integrating Flipped Instruction to Enhance Second Language Acquisition
Authors: Borja Ruiz de Arbulo Alonso
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This paper analyzes the impact of flipped instruction in adult learners of Spanish as a second language in a face-to-face course at Boston University. Given the limited amount of contact hours devoted to studying world languages in the American higher education system, implementing strategies to free up classroom time for communicative language practice is key to ensure student success in their learning process. In an effort to improve the way adult learners acquire a second language, this paper examines the role that regular pre-class and web-based exposure to Spanish grammar plays in student performance at the end of the academic term. It outlines different types of web-based pre-class activities and compares this approach to more traditional classroom practice. To do so, this study works for three months with two similar groups of adult learners in an intermediate-level Spanish class. Both groups use the same course program and have the same previous language experience, but one receives an additional set of instructor-made online materials containing a variety of grammar explanations and online activities that need to be reviewed before attending class. Since the online activities cover material and concepts that have not yet been studied in class, students' oral and written production in both groups is measured by means of a writing activity and an audio recording at the end of the three-month period. These assessments will ascertain the effects of exposing the control group to the grammar of the target language prior to each lecture throughout and demonstrate where flipped instruction helps adult learners of Spanish achieve higher performance, but also identify potential problems.Keywords: educational technology, flipped classroom, second language acquisition, student success
Procedia PDF Downloads 125882 Analysis of Career Support Programs for Olympic Athletes in Japan with Fifteen Conceptual Categories
Authors: Miyako Oulevey, Kaori Tsutsui, David Lavallee, Naohiko Kohtake
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The Japan Sports Agency has made efforts to unify several career support programs for Olympic athletes prior to the 2020 Tokyo Olympics. One of the programs, the Japan Olympic Committee Career Academy (JCA) was established in 2008 for Olympic athletes at their retirement. Research focusing on the service content of sport career support programs can help athletes experience a more positive transition. This study was designed to investigate the service content of the JCA program in relation to athletes’ career transition needs, including any differences of the reasons for retirement between Summer/Winter and Male/Female Olympic athletes, and to suggest the directions of how to unify the career support programs in Japan after hosting the Olympic Games using sport career transition models. Semi-structured interviews were conducted and analyzed the JCA director who started and managed the program since its inception, and a total of 15 conceptual categories were generated by the analysis. Four conceptual categories were in the result of “JCA situation”, 4 conceptual categories were in the result of “Athletes using JCA”, and 7 conceptual categories were in the result of “JCA current difficulties”. Through the analysis it was revealed that: the JCA had occupational supports for both current and retired Olympic athletes; other supports such as psychological support were unclear due to the lack of psychological professionals in JCA and the difficulties collaborating with other sports organizations; and there are differences in tendencies of visiting JCA, financial situations, and career choices depending on Summer/Winter and Male/Female athletes.Keywords: career support programs, causes of career termination, Olympic athlete, Olympic committee
Procedia PDF Downloads 145881 Ecotoxicity Evaluation Methodology for Metallurgical and Steel Wastes
Authors: G. Pelozo, N. Quaranta
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The assessment of environmental hazard and ecotoxicological potential of industrial wastes has become an issue of concern in many countries. Therefore, the aim of this work is to develop a methodology, adapting an Argentinian standard, which allows analyze the ecotoxicological effect of various metallurgical and steel wastes. Foundry sand, white mud, red mud, electric arc furnace dust, converter slag, among others, are the studied wastes. The species used to analyze the ecotoxicological effects of wastes is rye grass (Lolium Perenne). The choice of this kind lies, among other things, in its easy and rapid germination making it possible to develop the test in a few days. Moreover, since the processes involved are general for most seeds, the obtained results with this kind are representative, in general, of the effects on seeds or seedlings. Since the studied residues are solids, prior to performing the assay, an eluate is obtained by stirring for 2 hours and subsequent filtration of a solution of waste in water in a relationship of 1:4. This represents 100% of eluate from which two dilutions in water (25% and 50%) are prepared. A sample with untreated solid waste and water is also performed. The test is performed by placing two filter papers in a Petri dish that are saturated with 3.5ml of the prepared dilutions. After that 20 rye grass seeds are placed, and the Petri dishes are covered and the seeds are incubated for 120 hours at 24 °C. Reference controls are carried out by distilled water. Three replicates are performed for each concentration. Once the exposure period is finished, inhibiting elongation of the root is measured (IR). The results of this test show that all the studied wastes produce an unfavorable effect on the development of the seedlings, being the electric arc furnace dust which more affects the germination.Keywords: ecotoxicity, industrial wastes, environmental hazard, seeds
Procedia PDF Downloads 403880 Application of a Universal Distortion Correction Method in Stereo-Based Digital Image Correlation Measurement
Authors: Hu Zhenxing, Gao Jianxin
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Stereo-based digital image correlation (also referred to as three-dimensional (3D) digital image correlation (DIC)) is a technique for both 3D shape and surface deformation measurement of a component, which has found increasing applications in academia and industries. The accuracy of the reconstructed coordinate depends on many factors such as configuration of the setup, stereo-matching, distortion, etc. Most of these factors have been investigated in literature. For instance, the configuration of a binocular vision system determines the systematic errors. The stereo-matching errors depend on the speckle quality and the matching algorithm, which can only be controlled in a limited range. And the distortion is non-linear particularly in a complex imaging acquisition system. Thus, the distortion correction should be carefully considered. Moreover, the distortion function is difficult to formulate in a complex imaging acquisition system using conventional models in such cases where microscopes and other complex lenses are involved. The errors of the distortion correction will propagate to the reconstructed 3D coordinates. To address the problem, an accurate mapping method based on 2D B-spline functions is proposed in this study. The mapping functions are used to convert the distorted coordinates into an ideal plane without distortions. This approach is suitable for any image acquisition distortion models. It is used as a prior process to convert the distorted coordinate to an ideal position, which enables the camera to conform to the pin-hole model. A procedure of this approach is presented for stereo-based DIC. Using 3D speckle image generation, numerical simulations were carried out to compare the accuracy of both the conventional method and the proposed approach.Keywords: distortion, stereo-based digital image correlation, b-spline, 3D, 2D
Procedia PDF Downloads 498879 Simulating Human Behavior in (Un)Built Environments: Using an Actor Profiling Method
Authors: Hadas Sopher, Davide Schaumann, Yehuda E. Kalay
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This paper addresses the shortcomings of architectural computation tools in representing human behavior in built environments, prior to construction and occupancy of those environments. Evaluating whether a design fits the needs of its future users is currently done solely post construction, or is based on the knowledge and intuition of the designer. This issue is of high importance when designing complex buildings such as hospitals, where the quality of treatment as well as patient and staff satisfaction are of major concern. Existing computational pre-occupancy human behavior evaluation methods are geared mainly to test ergonomic issues, such as wheelchair accessibility, emergency egress, etc. As such, they rely on Agent Based Modeling (ABM) techniques, which emphasize the individual user. Yet we know that most human activities are social, and involve a number of actors working together, which ABM methods cannot handle. Therefore, we present an event-based model that manages the interaction between multiple Actors, Spaces, and Activities, to describe dynamically how people use spaces. This approach requires expanding the computational representation of Actors beyond their physical description, to include psychological, social, cultural, and other parameters. The model presented in this paper includes cognitive abilities and rules that describe the response of actors to their physical and social surroundings, based on the actors’ internal status. The model has been applied in a simulation of hospital wards, and showed adaptability to a wide variety of situated behaviors and interactions.Keywords: agent based modeling, architectural design evaluation, event modeling, human behavior simulation, spatial cognition
Procedia PDF Downloads 264878 Borrower Discouragement in Spain: An Empirical Analysis Using a Survey Data Set
Authors: Ginés Hernández-Cánovas, Mª Camino Ramón-Llorens, Johanna Koëter-Kant
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This paper uses a survey data-set of 837 Spanish SMEs to analyze the association between borrower discouragement and prior firm´s strategic decisions, while controlling for firm and owner characteristics. While existing literature has neglected factors limiting the demand for resources by an overreliance on arguments which attempt to explain the existence of discouraged borrowers solely in terms of lack of access to supply of credit. The objective of this paper is to show that factors limiting the demand for resources and, therefore, reducing the availability of funds, can be traced back to the firm manager´s decision. Our hypothesis is that managers that undertake strategic decisions seeking growth or improvement in their business performance participate more in the banking market than those showing contentment with their current business situation. Our results shows that SMEs that undertake an active role in research and development activities and that achieve improvements in the operating performance of their business are less likely to be discouraged from applying for a loan. Who needs credit and who applies for credit is important for firms, prospective lenders and policymakers interested in the financial health of these firms. Credit constrained firms are less likely to invest in R&D and to introduce new products, possibly harming long-term economic growth. Knowing how important borrower discouragement is in Europe, is important for judging the priority which should be attached to government policies aimed at reducing its effects. For example, policy makers could encourage the transparency about credit eligibility and conditions in order to reduce discouragement.Keywords: discouragement, financial constraints, SMEs financing
Procedia PDF Downloads 356877 Teachers’ Perceptions Related to the Guiding Skills within the Application Courses
Authors: Tanimola Kazeem Abiodun
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In Nigeria, both formal education and distance learning opportunities are used in teacher training. Practical courses aim to improve the skills of teacher candidates in a school environment. Teacher candidates attend kindergarten classes under the supervision of a teacher. In this context, the guiding skills of teachers gain importance in terms of shaping candidates’ perceptions about teaching profession. In this study, the teachers’ perceptions related to the guiding skills within the practical courses were determined. Also, the perceptions and applications related to guiding skills were compared. A Likert scale questionnaire and an open-ended question were used to determine perceptions and applications. 120 questionnaires were taken into consideration and analyses of data were performed by using percentage distribution and QSR Nvivo 8 program. In this study, statements related to teachers’ perceptions about the guiding skills were asked and it is determined that almost all the teachers agreed about the importance of these statements. On the other hand, how these guidance skills are applied by teachers is also queried with an open-ended question. Finally, thoughts and applications related to guidance skills were compared to each other. Based on this comparison, it is seen that there are some differences between the thoughts and applications especially related with time management, planning, feedbacks, curriculum, workload, rules and guidance. It can be said that some guidance skills cannot be controlled only by teachers. For example, candidates’ motivation, attention, population and educational environment are also determinative factors for effective guidance. In summary, it is necessary to have prior conditions for teachers to apply these idealized guidance skills for training more successful candidates to pre-school education era. At this point, organization of practical courses by the faculties gains importance and in this context it is crucial for faculties to revise their applications based on more detailed researches.Keywords: teacher training, guiding skills, education, practical courses
Procedia PDF Downloads 447876 Telemedicine in Physician Assistant Education: A Partnership with Community Agency
Authors: Martina I. Reinhold, Theresa Bacon-Baguley
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A core challenge of physician assistant education is preparing professionals for lifelong learning. While this conventionally has encompassed scientific advances, students must also embrace new care delivery models and technologies. Telemedicine, the provision of care via two-way audio and video, is an example of a technological advance reforming health care. During a three-semester sequence of Hospital Community Experiences, physician assistant students were assigned experiences with Answer Health on Demand, a telemedicine collaborative. Preceding the experiences, the agency lectured on the application of telemedicine. Students were then introduced to the technology and partnered with a provider. Prior to observing the patient-provider interaction, patient consent was obtained. Afterwards, students completed a reflection paper on lessons learned and the potential impact of telemedicine on their careers. Thematic analysis was completed on the students’ reflection papers (n=13). Preceding the lecture and experience, over 75% of students (10/13) were unaware of telemedicine. Several stated they were 'skeptical' about the effectiveness of 'impersonal' health care appointments. After the experience, all students remarked that telemedicine will play a large role in the future of healthcare and will provide benefits by improving access in rural areas, decreasing wait time, and saving cost. More importantly, 30% of students (4/13) commented that telemedicine is a technology they can see themselves using in their future practice. Initial results indicate that collaborative interaction between students and telemedicine providers enhanced student learning and exposed students to technological advances in the delivery of care. Further, results indicate that students perceived telemedicine more favorably as a viable delivery method after the experience.Keywords: collaboration, physician assistant education, teaching innovative health care delivery method, telemedicine
Procedia PDF Downloads 197875 Protective Effects of Genistein against Cyclophosphamide-Induced Hepatotoxicity in Rats: Involvement of Anti-Inflammatory and Anti-Oxidant Activities
Authors: Dina F. Mansour, Dalia O. Saleh, Rasha E. Mostafa
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Cyclophosphamide (CP), the most commonly used chemotherapeutic agent, was reported to cause many side effects including urotoxicity, cardiotoxicity, gonadotoxicity, and hepatotoxicity; this limits its clinical practice. In the present study, the protective effect of genistein (GEN), the major phytoestrogen in soy products that possesses various pharmacological activities, has been investigated against CP-induced acute liver damage in rats. Forty adult Sprague-Dawley rats were allocated into five groups. The first group received the vehicles and act as normal control. In the other groups, rats were injected with a single dose of CP (200 mg/kg, i.p). The last three groups were pretreated with subcutaneous GEN at doses of 0.5, 1 and 2 mg/kg/day, respectively, for 15 consecutive days prior CP injection. Forty-eight hours following CP injection, rats of all groups were investigated for the serum levels of alanine transaminase and aspartate transaminase, as well as the liver contents of reduced glutathione, malondialdehyde, nitrite, interleukin-1β, and myeloperoxidase. Histopathological examination of liver tissues was also conducted. CP resulted in acute liver damage in rats as evidenced by alteration of liver function biomarkers, oxidative stress, and inflammatory markers; that was confirmed by the histopathological outcomes. Pretreatment of rats with GEN significantly protected against CP-induced deterioration of liver function and showed marked anti-oxidant and anti-inflammatory properties that were demonstrated by the biochemical and histopathological findings. In conclusion, the present findings demonstrated the protective effects of GEN against CP-induced liver damage and suggested role of its antioxidant and anti-inflammatory activities.Keywords: cyclophosphamide, genistein, inflammation, interleukin-1β, liver, myeloperoxidase, oxidative stress
Procedia PDF Downloads 303874 Priority Analysis for Korean Disaster Mental Health Service Model Using Analytic Hierarchy Process
Authors: Myung-Soo Lee, Sun-Jin Jo, Kyoung-Sae Na, Joo-Eon Park
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Early intervention after a disaster is important for recovery of disaster victims and each country has its own professional mental health service system such as Disaster Psychiatric Assistant Team in Japan and Crisis Counseling Program in the USA. The purpose of this study was to determine key prior components of the Korean Disaster Psychiatric Assistant Team (K-DPAT) for building up Korean disaster mental health service system. We conducted an Analytic Hierarchy Process(AHP) with disaster mental health experts using pairwise comparison questionnaire which compares the relative importance of the key components of Korean disaster mental health service system. Forty-one experts answered the first online survey, and among them, 36 responded to the second. Ten experts were participated in panel meeting and discussed the results of the survey and AHP process. Participants decided the relative importance of the Korean disaster mental health service system regarding initial professional intervention as follows. K-DPAT could be organized at a national level (43.0%) or regional level (40.0%). K-DPAT members should be managed (59.0%) and educated (52.1%) by national level than regional or local level. K-DPAT should be organized independent of the preexisting mental health system (70.1%). Funding for K-DPAT should be from the Ministry of Public Safety and the system could be managed by Ministry of Health (65.8%). Experts agreed K-DPAT leader is suitable for key decision maker for most types of disaster except infectious disease. We expect new model for disaster mental health services can improve insufficiency of the system such as fragmentation and decrease the unmet needs of early professional intervention for the disaster victims.Keywords: analytic hierarchy process, decision making, disaster, DPAT, mental health services
Procedia PDF Downloads 275873 Overcoming Open Innovation Challenges with Technology Intelligence: Case of Medium-Sized Enterprises
Authors: Akhatjon Nasullaev, Raffaella Manzini, Vincent Frigant
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The prior research largely discussed open innovation practices both in large and small and medium-sized enterprises (SMEs). Open Innovation compels firms to observe and analyze the external environment in order to tap new opportunities for inbound and/or outbound flows of knowledge, ideas, work in progress innovations. As SMEs are different from their larger counterparts, they face several limitations in utilizing open innovation activities, such as resource scarcity, unstructured innovation processes and underdeveloped innovation capabilities. Technology intelligence – the process of systematic acquisition, assessment and communication of information about technological trends, opportunities and threats can mitigate this limitation by enabling SMEs to identify technological and market opportunities in timely manner and undertake sound decisions, as well as to realize a ‘first mover advantage’. Several studies highlighted firm-level barriers to successful implementation of open innovation practices in SMEs, namely challenges in partner selection, intellectual property rights and trust, absorptive capacity. This paper aims to investigate the question how technology intelligence can be useful for SMEs to overcome the barriers to effective open innovation. For this, we conduct a case study in four Estonian life-sciences SMEs. Our findings revealed that technology intelligence can support SMEs not only in inbound open innovation (taking into account inclination of most firms toward technology exploration aspects of open innovation) but also outbound open innovation. Furthermore, the results of this study state that, although SMEs conduct technology intelligence in unsystematic and uncoordinated manner, it helped them to increase their innovative performance.Keywords: technology intelligence, open innovation, SMEs, life sciences
Procedia PDF Downloads 167872 Excited State Structural Dynamics of Retinal Isomerization Revealed by a Femtosecond X-Ray Laser
Authors: Przemyslaw Nogly, Tobias Weinert, Daniel James, Sergio Carbajo, Dmitry Ozerov, Antonia Furrer, Dardan Gashi, Veniamin Borin, Petr Skopintsev, Kathrin Jaeger, Karol Nass, Petra Bath, Robert Bosman, Jason Koglin, Matthew Seaberg, Thomas Lane, Demet Kekilli, Steffen Brünle, Tomoyuki Tanaka, Wenting Wu, Christopher Milne, Thomas A. White, Anton Barty, Uwe Weierstall, Valerie Panneels, Eriko Nango, So Iwata, Mark Hunter, Igor Schapiro, Gebhard Schertler, Richard Neutze, Jörg Standfuss
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Ultrafast isomerization of retinal is the primary step in a range of photoresponsive biological functions including vision in humans and ion-transport across bacterial membranes. We studied the sub-picosecond structural dynamics of retinal isomerization in the light-driven proton pump bacteriorhodopsin using an X-ray laser. Twenty snapshots with near-atomic spatial and temporal resolution in the femtosecond regime show how the excited all-trans retinal samples conformational states within the protein binding pocket prior to passing through a highly-twisted geometry and emerging in the 13-cis conformation. The aspartic acid residues and functional water molecules in proximity of the retinal Schiff base respond collectively to formation and decay of the initial excited state and retinal isomerization. These observations reveal how the protein scaffold guides this remarkably efficient photochemical reaction.Keywords: bacteriorhodopsin, free-electron laser, retinal isomerization mechanism, time-resolved crystallography
Procedia PDF Downloads 248871 Unpacking the Summarising Event in Trauma Emergencies: The Case of Pre-briefings
Authors: Professor Jo Angouri, Polina Mesinioti, Chris Turner
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In order for a group of ad-hoc professional to perform as a team, a shared understanding of the problem at hand and an agreed action plan are necessary components. This is particularly significant in complex, time sensitive professional settings such as in trauma emergencies. In this context, team briefings prior to the patient arrival (pre-briefings) constitute a critical event for the performance of the team; they provide the necessary space for co-constructing a shared understanding of the situation through summarising information available to the team: yet the act of summarising is widely assumed in medical practice but not systematically researched. In the vast teamwork literature, terms such as ‘shared mental model’, ‘mental space’ and ‘cognate labelling’ are used extensively, and loosely, to denote the outcome of the summarising process, but how exactly this is done interactionally remains under researched. This paper reports on the forms and functions of pre-briefings in a major trauma centre in the UK. Taking an interactional approach, we draw on 30 simulated and real-life trauma emergencies (15 from each dataset) and zoom in on the use of pre-briefings, which we consider focal points in the management of trauma emergencies. We show how ad hoc teams negotiate sharedness of future orientation through summarising, synthesising information, and establishing common understanding of the situation. We illustrate the role, characteristics, and structure of pre-briefing sequences that have been evaluated as ‘efficient’ in our data and the impact (in)effective pre-briefings have on teamwork. Our work shows that the key roles in the event own the act of summarising and we problematise the implications for leadership in trauma emergencies. We close the paper with a model for pre-briefing and provide recommendations for clinical practice, arguing that effective pre-briefing practice is teachable.Keywords: summarising, medical emergencies, interaction analysis, shared/mental models
Procedia PDF Downloads 93870 Influence of Organic Supplements on Shoot Multiplication Efficiency of Phaius tankervilleae var. alba
Authors: T. Punjansing, M. Nakkuntod, S. Homchan, P. Inthima, A. Kongbangkerd
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The influence of organic supplements on growth and multiplication efficiency of Phaius tankervilleae var. alba seedlings was investigated. 12 week-old seedlings were cultured on half-strength semi-solid Murashige and Skoog (MS) medium supplemented with 30 g/L sucrose, 8 g/L agar and various concentrations of coconut water (0, 50, 100, 150 and 200 mL/L) combined with potato extract (0, 25 and 50 g/L) and the pH was adjusted to 5.8 prior to autoclaving. The cultures were then kept under constant photoperiod (16 h light: 8 h dark) at 25 ± 2 °C for 12 weeks. The highest number of shoots (3.0 shoots/explant) was obtained when cultured on the medium added with 50 ml/L coconut water and 50 g/L potato extract whereas the highest number of leaves (5.9 leaves/explant) and roots (6.1 roots/explant) could receive on the medium supplemented with 150 ml/L coconut water and 50 g/L potato extract. with 150 ml/L coconut water and 50 g/L potato extract. Additionally, plantlets of P. tankervilleae var. alba were transferred to grow into seven different substrates i.e. soil, sand, coconut husk chip, soil-sand mix (1: 1), soil-coconut husk chip mix (1: 1), sand-coconut husk chip mix (1: 1) and soil-sand-coconut husk chip mix (1: 1: 1) for four weeks. The results found that acclimatized plants showed 100% of survivals when sand, coconut husk chip and sand-coconut husk chip mix are used as substrates. The number of leaves induced by sand-coconut husk chip mix was significantly higher than that planted in other substrates (P > 0.05). Meanwhile, no significant difference in new shoot formation among these substrates was observed (P < 0.05). This precursory developing protocol was likely to be applied for more large scale of plant production as well as conservation of germplasm of this orchid species.Keywords: organic supplements, acclimatization, Phaius tankervilleae var. alba, orchid
Procedia PDF Downloads 229869 Establishment of Virtual Fracture Clinic in Princess Royal Hospital Telford: Experience and Recommendations during the First 9 Months
Authors: Tahir Khaleeq, Patrick Lancaster, Keji Fakoya, Pedro Ferreira, Usman Ahmed
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Introduction: Virtual fracture clinics (VFC) have been shown to be a safe and cost-effective way of managing outpatient referrals to the orthopaedic department. During the coronavirus pandemic there has been a push to reduce unnecessary patient contact whilst maintaining patient safety. Materials and Methods: A protocol was developed by the clinical team in collaboration with Advanced Physiotherapy Practitioners (APP) on how to manage common musculoskeletal presentations to A&E prior to COVID as part of routine service development. Patients broadly triaged into 4 categories; discharge with advice, referral to VFC, referral to face to face clinic or discussion with on call team. The first 9 months of data were analysed to assess types of injury seen and outcomes. Results: In total 2489 patients were referred to VFC from internal and external sources. 734 patients were discharged without follow-up and 182 patients were discharged for physiotherapy review. Only 3 patients required admission. Regarding follow-ups, 431 patients had a virtual follow-up while 1036 of patients required further face to face follow up. 87 patients were triaged into subspecialty clinics. 37 patients were felt to have been referred inappropriately. Discussion: BOA guidelines suggest all patients need to be reviewed within 72 hours of their orthopaedic injury. Implementation of a VFC allows this target to be achieved and at the same time reduce patient contact. Almost half the patients were discharged following VFC review, the remaining patients were appropriately followed up. This is especially relevant in the current pandemic where reducing unnecessary trips to hospital will benefit the patient as well as make the most of the resources available.Keywords: virtual fracture clinic, lockdown, trauma and orthopaedics, Covid- 19
Procedia PDF Downloads 201868 Applying the Information System to Enhance the Management of Perioperative Nursing
Authors: Ya-Yi Yen
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The operating room is a medical environment full of high-risk, high-complexity and high-cost. In addition to assuring patient safety, the operating room should effort on the efficient and safe medical quality for the surgical patients of high risk, elders, and children. If the nursing staffs of operation room carry on the pre-operative visiting prior to surgery, the patient's anxiety and complications are expected to be alleviated, and the hospitalization days may also be shortened. Purpose: Applying the information system to enhance pre-operative visiting, case tracking, and effectiveness recording Method: (I) Application the information system to screen cases by integrating the operation scheduling, and linking the severe surgery codes, for to shorten the time to track cases of operative visiting. Through the improvement, the time required decreased to 1.5 minutes per day from 20 minutes per day, and nursing staffs’ satisfaction with satisfaction for tracking and visiting procedure of case increased to 86% from 54%. (II)The electronic establishment of the operative visiting record enhanced the integrity of the operative visiting record. The integrity rate was rise to 92% from 66%, while nursing staffs’ satisfaction with the visiting record increased to 82% from 61.3%. Since information technology continues evolving, the application of information technology is helpful to the integration of nursing information, simplification of processes, and saving of man-hours. This article introduces the application of information systems to simplify the processes and improve the effectiveness of operation visiting and tracking, including the saving of time, improving the integrity rate of record, and improving the satisfaction of nursing staffs.Keywords: effectiveness, information system, perioperative nursing, pre-operative visiting
Procedia PDF Downloads 143867 Use of Corn Stover for the Production of 2G Bioethanol, Enzymes, and Xylitol Under a Biorefinery Concept
Authors: Astorga-Trejo Rebeca, Fonseca-Peralta Héctor Manuel, Beltrán-Arredondo Laura Ivonne, Castro-Martínez Claudia
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The use of biomass as feedstock for the production of fuels and other chemicals of interest is an ever-growing accepted option in the way to the development of biorefinery complexes; in the Mexican state of Sinaloa, two million tons of residues from corn crops are produced every year, most of which can be converted to bioethanol and other products through biotechnological conversion using yeast and other microorganisms. Therefore, the objective of this work was to take advantage of corn stover and evaluate its potential as a substrate for the production of second-generation bioethanol (2G), enzymes, and xylitol. To produce bioethanol 2G, an acid-alkaline pretreatment was carried out prior to saccharification and fermentation. The microorganisms used for the production of enzymes, as well as for the production of xylitol, were isolated and characterized in our workgroup. Statistical analysis was performed using Design Expert version 11.0. The results showed that it is possible to obtain 2G bioethanol employing corn stover as a carbon source and Saccharomyces cerevisiae ItVer01 and Candida intermedia CBE002 with yields of 0.42 g and 0.31 g, respectively. It was also shown that C. intermedia has the ability to produce xylitol with a good yield (0.46 g/g). On the other hand, qualitative and quantitative studies showed that the native strains of Fusarium equiseti (0.4 IU/mL - xylanase), Bacillus velezensis (1.2 IU/mL – xylanase and 0.4 UI/mL - amylase) and Penicillium funiculosum (1.5 IU / mL - cellulases) have the capacity to produce xylanases, amylases or cellulases using corn stover as raw material. This study allowed us to demonstrate that it is possible to use corn stover as a carbon source, a low-cost raw material with high availability in our country, to obtain bioproducts of industrial interest, using processes that are more environmentally friendly and sustainable. It is necessary to continue the optimization of each bioprocess.Keywords: biomass, corn stover, biorefinery, bioethanol 2G, enzymes, xylitol
Procedia PDF Downloads 170866 Regression Analysis in Estimating Stream-Flow and the Effect of Hierarchical Clustering Analysis: A Case Study in Euphrates-Tigris Basin
Authors: Goksel Ezgi Guzey, Bihrat Onoz
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The scarcity of streamflow gauging stations and the increasing effects of global warming cause designing water management systems to be very difficult. This study is a significant contribution to assessing regional regression models for estimating streamflow. In this study, simulated meteorological data was related to the observed streamflow data from 1971 to 2020 for 33 stream gauging stations of the Euphrates-Tigris Basin. Ordinary least squares regression was used to predict flow for 2020-2100 with the simulated meteorological data. CORDEX- EURO and CORDEX-MENA domains were used with 0.11 and 0.22 grids, respectively, to estimate climate conditions under certain climate scenarios. Twelve meteorological variables simulated by two regional climate models, RCA4 and RegCM4, were used as independent variables in the ordinary least squares regression, where the observed streamflow was the dependent variable. The variability of streamflow was then calculated with 5-6 meteorological variables and watershed characteristics such as area and height prior to the application. Of the regression analysis of 31 stream gauging stations' data, the stations were subjected to a clustering analysis, which grouped the stations in two clusters in terms of their hydrometeorological properties. Two streamflow equations were found for the two clusters of stream gauging stations for every domain and every regional climate model, which increased the efficiency of streamflow estimation by a range of 10-15% for all the models. This study underlines the importance of homogeneity of a region in estimating streamflow not only in terms of the geographical location but also in terms of the meteorological characteristics of that region.Keywords: hydrology, streamflow estimation, climate change, hydrologic modeling, HBV, hydropower
Procedia PDF Downloads 129865 Antioxidative Maillard Reaction Products Derived from Gelatin Hydrolysate of Unicorn Leatherjacket Skin
Authors: Supatra Karnjanapratum, Soottawat Benjakul
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Gelatin hydrolysate, especially from marine resource, has been known to possess antioxidative activity. Nevertheless, the activity is still lower in comparison with the commercially available antioxidant. Maillard reactions can be use to increase antioxidative activity of gelatin hydrolysate, in which the numerous amino group could be involved in glycation. In the present study, gelatin hydrolysate (GH) from unicorn leatherjacket skin prepared using glycyl endopeptidase with prior autolysis assisted process was used for preparation of Maillard reaction products (MRPs) under dry condition. The impacts of different factors including, types of saccharides, GH to saccharide ratio, incubation temperatures, relative humidity (RH) and times on antioxidative activity of MRPs were investigated. MRPs prepared using the mixture of GH and galactose showed the highest antioxidative activity as determined by both ABTS radical scavenging activity and ferric reducing antioxidant power during heating (0-48 h) at 60 °C with 65% RH, compared with those derived from other saccharide tested. GH to galactose ratio at 2:1 (w/w) yielded the MRPs with the highest antioxidative activity, followed by the ratios of 1:1 and 1:2, respectively. When the effects of incubation temperatures (50, 60, 70 °C) and RH (55, 65, 75%) were examined, the highest browning index and the absorbance at 280 nm were found at 70 °C, regardless of RH. The pH and free amino group content of MRPs were decreased with the concomitant increase in antioxidative activity as the reaction time increased. Antioxidative activity of MRPs generally increased with increasing temperature and the highest antioxidative activity was found when RH of 55% was used. Based on electrophoresis of MRP, the polymerization along with the formation of high molecular weight material was observed. The optimal condition for preparing antioxidative MRPs was heating the mixture of GH and galactose (2:1) at 70 °C and 55% RH for 36 h. Therefore, antioxidative activity of GH was improved by Maillard reaction and the resulting MRP could be used as natural antioxidant in food products.Keywords: antioxidative activity, gelatin hydrolysate, maillard reaction, unicorn leatherjacket
Procedia PDF Downloads 248864 Bridging the Divide: Mixed-Method Analysis of Student Engagement and Outcomes in Diverse Postgraduate Cohorts
Authors: A.Knox
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Student diversity in postgraduate classes puts major challenges on educators seeking to encourage student engagement and desired to learn outcomes. This paper outlines the impact of a set of teaching initiatives aimed at addressing challenges associated with teaching and learning in an environment characterized by diversity in the student cohort. The study examines postgraduate students completing the core capstone unit within a specialized business degree. Although relatively small, the student cohort is highly diverse in terms of cultural backgrounds represented, prior learning and/or qualifications, as well as duration and type of work experience relevant to the degree, is completed. The wide range of cultures, existing knowledge and experience create enormous challenges with respect to students’ learning needs and outcomes. Subsequently, a suite of teaching innovations has been adopted to enhance curriculum content/delivery and the design of assessments. This paper explores the impact of these specific teaching and learning practices, examining the ways they have supported students’ diverse needs and enhanced students’ learning outcomes. Data from surveys and focus groups are used to assess the effectiveness of these practices. The results highlight the effectiveness of peer-assisted learning, cultural competence-building, and advanced assessment options in addressing diverse student needs and enhancing student engagement and learning outcomes. These findings suggest that such practices would benefit students’ learning in environments marked by diversity in the student cohort. Specific recommendations are offered for other educators working with diverse classes.Keywords: assessment design, curriculum content, curriculum delivery, student diversity
Procedia PDF Downloads 110863 Safety Testing of Commercial Lithium-Ion Batteries and Failure Modes Analysis
Authors: Romeo Malik, Yashraj Tripathy, Anup Barai
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Transportation safety is a major concern for vehicle electrification on a large-scale. The failure cost of lithium-ion batteries is substantial and is significantly impacted by higher liability and replacement cost. With continuous advancement on the material front in terms of higher energy density, upgrading safety characteristics are becoming more crucial for broader integration of lithium-ion batteries. Understanding and impeding thermal runaway is the prime issue for battery safety researchers. In this study, a comprehensive comparison of thermal runaway mechanisms for two different cathode types, Li(Ni₀.₃Co₀.₃Mn₀.₃)O₂ and Li(Ni₀.₈Co₀.₁₅Al₀.₀₅)O₂ is explored. Both the chemistries were studied for different states of charge, and the various abuse scenarios that lead to thermal runaway is investigated. Abuse tests include mechanical abuse, electrical abuse, and thermal abuse. Batteries undergo thermal runaway due to a series of combustible reactions taking place internally; this is observed as multiple jets of flame reaching temperatures of the order of 1000ºC. The physicochemical characterisation was performed on cells, prior to and after abuse. Battery’s state of charge and chemistry have a significant effect on the flame temperature profiles which is otherwise quantified as heat released. Majority of the failures during transportation is due to these external short circuit. Finally, a mitigation approach is proposed to impede the thermal runaway hazard. Transporting lithium-ion batteries under low states of charge is proposed as a way forward. Batteries at low states of charge have demonstrated minimal heat release under thermal runaway reducing the risk of secondary hazards such as thermal runaway propagation.Keywords: battery reliability, lithium-ion batteries, thermal runaway characterisation, tomography
Procedia PDF Downloads 122862 Performance Evaluation of Polyethyleneimine/Polyethylene Glycol Functionalized Reduced Graphene Oxide Membranes for Water Desalination via Forward Osmosis
Authors: Mohamed Edokali, Robert Menzel, David Harbottle, Ali Hassanpour
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Forward osmosis (FO) process has stood out as an energy-efficient technology for water desalination and purification, although the practical application of FO for desalination still relies on RO-based Thin Film Composite (TFC) and Cellulose Triacetate (CTA) polymeric membranes which have a low performance. Recently, graphene oxide (GO) laminated membranes have been considered an ideal selection to overcome the bottleneck of the FO-polymeric membranes owing to their simple fabrication procedures, controllable thickness and pore size and high water permeability rates. However, the low stability of GO laminates in wet and harsh environments is still problematic. The recent developments of modified GO and hydrophobic reduced graphene oxide (rGO) membranes for FO desalination have demonstrated attempts to overcome the ongoing trade-off between desalination performance and stability, which is yet to be achieved prior to the practical implementation. In this study, acid-functionalized GO nanosheets cooperatively reduced and crosslinked by the hyperbranched polyethyleneimine (PEI) and polyethylene glycol (PEG) polymers, respectively, are applied for fabrication of the FO membrane, to enhance the membrane stability and performance, and compared with other functionalized rGO-FO membranes. PEI/PEG doped rGO membrane retained two compacted d-spacings (0.7 and 0.31 nm) compared to the acid-functionalized GO membrane alone (0.82 nm). Besides increasing the hydrophilicity, the coating layer of PEG onto the PEI-doped rGO membrane surface enhanced the structural integrity of the membrane chemically and mechanically. As a result of these synergetic effects, the PEI/PEG doped rGO membrane exhibited a water permeation of 7.7 LMH, salt rejection of 97.9 %, and reverse solute flux of 0.506 gMH at low flow rates in the FO desalination process.Keywords: desalination, forward osmosis, membrane performance, polyethyleneimine, polyethylene glycol, reduced graphene oxide, stability
Procedia PDF Downloads 98861 Support for and Participation in 'Spontaneous' Mass Protest in Iceland: The Moderating Effects of Biographical Availability, Critical Mass, and Social Embeddedness
Authors: Jon Gunnar Bernburg
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The present study addresses a topic that is fundamental to social movement theory, namely, the contingent link between movement support and movement participation. Usually, only a small fraction of those who agree with the cause of a social movement is mobilized into participating in it (a pattern sometimes referred to as 'the collective action problem'). However, historical moments sometimes emerge when many supporters become mobilized to participate in the movement, greatly enhancing the chance of movement success. By studying a case in point, this paper addresses the limited work on how support and participation are related at such critical moments. Specifically, the paper examines the association between supporting and participating in a huge 'pro-democracy' protest in Iceland in April 2016, in the wake of the global Panama Papers scandal. Organized via social media by only a handful of activists, but supported by a majority of Icelanders, the protest attracted about a fourth of the urban population, leading to a snap election and government change. Surveying Iceland’s urban population, this paper tests hypotheses about the processes mobilizing supporters to participate in the protest. The findings reveal how variables derived from the theories of biographical availability (males vs. females, working class vs. professionals), critical mass (expectations, prior protest success), and social embeddedness (close ties with protesters) moderate the association between protest support and participation. The study helps to account for one of the largest protests in Iceland’s history while contributing to the theory about how historical contexts shape the behavior of movement supporters.Keywords: Iceland, crisis, protest support vs. participation, theories of mass mobilization
Procedia PDF Downloads 235860 Reliability Qualification Test Plan Derivation Method for Weibull Distributed Products
Authors: Ping Jiang, Yunyan Xing, Dian Zhang, Bo Guo
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The reliability qualification test (RQT) is widely used in product development to qualify whether the product meets predetermined reliability requirements, which are mainly described in terms of reliability indices, for example, MTBF (Mean Time Between Failures). It is widely exercised in product development. In engineering practices, RQT plans are mandatorily referred to standards, such as MIL-STD-781 or GJB899A-2009. But these conventional RQT plans in standards are not preferred, as the test plans often require long test times or have high risks for both producer and consumer due to the fact that the methods in the standards only use the test data of the product itself. And the standards usually assume that the product is exponentially distributed, which is not suitable for a complex product other than electronics. So it is desirable to develop an RQT plan derivation method that safely shortens test time while keeping the two risks under control. To meet this end, for the product whose lifetime follows Weibull distribution, an RQT plan derivation method is developed. The merit of the method is that expert judgment is taken into account. This is implemented by applying the Bayesian method, which translates the expert judgment into prior information on product reliability. Then producer’s risk and the consumer’s risk are calculated accordingly. The procedures to derive RQT plans are also proposed in this paper. As extra information and expert judgment are added to the derivation, the derived test plans have the potential to shorten the required test time and have satisfactory low risks for both producer and consumer, compared with conventional test plans. A case study is provided to prove that when using expert judgment in deriving product test plans, the proposed method is capable of finding ideal test plans that not only reduce the two risks but also shorten the required test time as well.Keywords: expert judgment, reliability qualification test, test plan derivation, producer’s risk, consumer’s risk
Procedia PDF Downloads 137859 Retrospective/Prospective Analysis of Guideline Implementation and Transfusion Rates
Authors: B. Kenny
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The complications associated with transfusions are well documented, with the serious hazards of transfusion (SHOT) reporting system continuing to report deaths and serious morbidity due to the transfusion of allogenic blood. Many different sources including the TRICC trial, NHMRC and Cochrane recommending similar transfusion triggers/guidelines. Recent studies found the rate of infection (deep infection, wound infection, chest infection, urinary tract infection, and others) were purely a dose response relationship, increasing the Relative Risk by 3.44. It was also noted that each transfused patient stayed in hospital for one additional day. We hypothesise that providing an approved/standardised, guideline with a graphical summary of decision pathways for anaemic patients will reduce unnecessary transfusions. We retrospectively assessed patients undergoing primary knee or hip arthroplasties over a 4 year period, 1459 patients. Of these, 339 (23.24%) patients received allogenic blood transfusions and 858 units of blood were transfused, 9.14% of patients transfused had haemoglobin levels above 100 g/L, 7.67% of patients were transfused without knowing the haemoglobin level, 24 hours prior to transfusion initiation and 4.5% had possible transfusion reactions. Overall, 17% of allogenic transfusions topatients admitted to the Orthopaedic department within a 4 year period were outside NHMRC and Cochrane guidelines/recommendations. If our transfusion frequency is compared with that of other authors/hospitals, transfusion rates are consistently being high. We subsequently implemented a simple guideline for transfusion initiation. This guideline was then assessed. We found the transfusion rate post transfusion implementation to be significantly lower, without increase in patient morbidity or mortalitiy, p <0.001). Transfusion rates and patient outcome can be optimized by a simple graphical aid for decision making.Keywords: transfusion, morbidity, mortality, neck of femur, fracture, arthroplasty, rehabilitation
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